Black women in America and prevention of cervical cancer

Many people may believe that cervical cancer is a problem of the past. Before the 1940s, it was one of the leading causes of death among women of childbearing age. According to the National Institute of Health, invasive cervical cancer is now considered the 14th leading cause of cancer death among women in the United States. This represents approximately 4,000 female deaths each year.

African-American women are twice as likely as Caucasian women to be diagnosed with invasive cancer of the cervix and 2 to 3 times more likely to die from this diagnosis. Before examining why this health disparity exists, let's explore the historical benefits that have helped reduce the number of deaths and diagnoses of invasive cervical cancer.

Before the 1940s, it was difficult to diagnose cervical cancer if significant symptoms such as bleeding, pain, and nausea occurred, forcing women to come forward later. In 1943, Dr. George Papanicolau published an article on his work to identify normal or cancerous cervical changes under the microscope before invasive cancer occurs in an article entitled "Diagnosis of Uterine Cancer in Pap smear" .

In 1954, Dr. Papanicolau published his atlas for laboratories to learn how to identify cervical cancer with the help of his method. It is now a Papanicolau test or smear. We are now using it to detect cervical cancer and detect it in its infancy. Cervical cancer detected at early stages can be removed through minor surgical procedures and, in many cases, hysterectomy can be avoided.

In the 1970s, the HPV virus was the subject of much research as a possible link with cervical cancer. In 1984, Dr. Harald zur Hausen discovered that HPV 16 and 18 were the leading causes of cervical cancer. He then won a Nobel Prize for science for this discovery. In the 1990s, Dr. Lowy and Dr. Schiller began creating an HPV vaccine that could help prevent cervical cancer. In 2006, the FDA approved the first anti-HPV vaccines.

We now use the HPV vaccine to help prevent cervical cancer. This is particularly important at the international level as currently 500,000 women are diagnosed with cervical cancer and 275,000 of them will die from this disease due to limited access to screening and treatment.

Cervical cancer has made so much progress in treatment and diagnosis in the United States that even a single death from this disease could be considered a failure of the system. But about 700 African-American women still die of cervical cancer each year. The three main reasons are: the late stage of diagnosis, less aggressive treatment and additional barriers to care once diagnosed.

One of the reasons given for the lack of early detection is the confusion between the Pap smear and the pelvic exam, which makes one think of a person that she has already been the subject of Screening, although it may have undergone this examination for a different reason. Many African American women do not receive treatment because of concomitant conditions, advanced cancer or treatment refusal. In 2016, Nardi et al. Have detailed some of the findings from many studies indicating that lack of knowledge about cervical cancer may be the biggest barrier to screening and treating cervical cancer in African American women.